Dorothy Rene Herdman, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CSW002956 Issued in GA

Practice address

220 Uvalda St
Waycross, GA 31501-4569

Phone

(912) 285-2487

NPI assigned

Jun 19, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ms. Dorothy Rene Herdman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912102948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 HOLLY ST",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315221304",
            "telephone_number": "912-634-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 UVALDA ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014569",
            "telephone_number": "912-285-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERDMAN",
        "first_name": "DOROTHY",
        "middle_name": "RENE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "CSW002956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SW LICENSE",
            "identifier": "CSW002956",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE-SOCIALWORK",
            "identifier": "SW1720",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOROTHY",
            "last_name": "HERDMAN",
            "middle_name": "RENE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lori Henderson, NP-C
• Tiffany Henderson, LCSW
• Sandra T Hendrickson
• Amy Hendrix-Bennett
• Fady Henein, MD
• Allison Callaway Herrin, CCC-SLP
• Caroline Herrin
• Natasha Williams Herrin, LSCSW
• Anthony Cal Herrington, NP
• John Herrington

• Mental Health Counselor in Waycross, GA
• Providers in Waycross, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.